The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study
Abstract Background Suspected penicillin allergy (Pen-A) is often not verified by diagnostic testing. In third line penicillin allergy labels were associated with prescription of broad spectrum antibiotics, hospital stay duration and readmission. Objective Assess the impact of Pen-A labels on antibi...
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| Format: | Article |
| Language: | English |
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Wiley
2017-06-01
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| Series: | Clinical and Translational Allergy |
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| Online Access: | http://link.springer.com/article/10.1186/s13601-017-0154-y |
| _version_ | 1831568419376332800 |
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| author | Tanly Su Berna D. L. Broekhuizen Theo J. M. Verheij Heike Rockmann |
| author_facet | Tanly Su Berna D. L. Broekhuizen Theo J. M. Verheij Heike Rockmann |
| author_sort | Tanly Su |
| collection | DOAJ |
| description | Abstract Background Suspected penicillin allergy (Pen-A) is often not verified by diagnostic testing. In third line penicillin allergy labels were associated with prescription of broad spectrum antibiotics, hospital stay duration and readmission. Objective Assess the impact of Pen-A labels on antibiotic and health care use in primary care. Methods A retrospective cohort study was conducted in primary care in the Utrecht area, the Netherlands. All patients registered with a penicillin allergy on 31 December 2013 were selected from the General Practitioner Network database. Each patient with a Pen-A label was matched for age, gender, follow-up period with three patients without Pen-A label. Risk (OR) of receiving a reserve and second choice antibiotic, number and type of antibiotics prescribed during follow-up and number of GP contacts were compared between the two cohorts. Results Of 196,440 patients, 1254 patients (0.6%) with a Pen-A label were identified and matched with 3756 patients without Pen-A label. Pen-A labels resulted in higher risk of receiving ≥1 antibiotic prescription per year (OR 2.56, 95% CI 2.05–3.20), ≥1 s choice antibiotic prescription per year (OR 2.21 95% CI 1.11–4.40), and ≥4 GP contacts per year (OR 1.71 95% CI 1.46–2.00). The chance of receiving tetracyclins (OR 2.24, 95% CI 1.29–3.89), macrolides/lincosamides/streptogamins (OR 8.69, 95% CI 4.26–17.73) and quinolones (OR 2.59, 95% CI 1.22–5.48) was higher in Pen-A patients. Conclusions In primary health care Pen-A labels are associated with increased antibiotic use, including second choice antibiotics, and more health care use. |
| first_indexed | 2024-12-17T12:15:30Z |
| format | Article |
| id | doaj.art-90ca452ec7524950938e3038d6c5a21d |
| institution | Directory Open Access Journal |
| issn | 2045-7022 |
| language | English |
| last_indexed | 2024-12-17T12:15:30Z |
| publishDate | 2017-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Allergy |
| spelling | doaj.art-90ca452ec7524950938e3038d6c5a21d2022-12-21T21:49:11ZengWileyClinical and Translational Allergy2045-70222017-06-01711710.1186/s13601-017-0154-yThe impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort studyTanly Su0Berna D. L. Broekhuizen1Theo J. M. Verheij2Heike Rockmann3Julius Center for Health Sciences and Primary Care, University Medical Center UtrechtJulius Center for Health Sciences and Primary Care, University Medical Center UtrechtJulius Center for Health Sciences and Primary Care, University Medical Center UtrechtDepartment of Dermatology and Allergology, University Medical Center UtrechtAbstract Background Suspected penicillin allergy (Pen-A) is often not verified by diagnostic testing. In third line penicillin allergy labels were associated with prescription of broad spectrum antibiotics, hospital stay duration and readmission. Objective Assess the impact of Pen-A labels on antibiotic and health care use in primary care. Methods A retrospective cohort study was conducted in primary care in the Utrecht area, the Netherlands. All patients registered with a penicillin allergy on 31 December 2013 were selected from the General Practitioner Network database. Each patient with a Pen-A label was matched for age, gender, follow-up period with three patients without Pen-A label. Risk (OR) of receiving a reserve and second choice antibiotic, number and type of antibiotics prescribed during follow-up and number of GP contacts were compared between the two cohorts. Results Of 196,440 patients, 1254 patients (0.6%) with a Pen-A label were identified and matched with 3756 patients without Pen-A label. Pen-A labels resulted in higher risk of receiving ≥1 antibiotic prescription per year (OR 2.56, 95% CI 2.05–3.20), ≥1 s choice antibiotic prescription per year (OR 2.21 95% CI 1.11–4.40), and ≥4 GP contacts per year (OR 1.71 95% CI 1.46–2.00). The chance of receiving tetracyclins (OR 2.24, 95% CI 1.29–3.89), macrolides/lincosamides/streptogamins (OR 8.69, 95% CI 4.26–17.73) and quinolones (OR 2.59, 95% CI 1.22–5.48) was higher in Pen-A patients. Conclusions In primary health care Pen-A labels are associated with increased antibiotic use, including second choice antibiotics, and more health care use.http://link.springer.com/article/10.1186/s13601-017-0154-yAllergy registrationPenicillin allergyDrug hypersensitivityAntimicrobial stewardshipPrimary care |
| spellingShingle | Tanly Su Berna D. L. Broekhuizen Theo J. M. Verheij Heike Rockmann The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study Clinical and Translational Allergy Allergy registration Penicillin allergy Drug hypersensitivity Antimicrobial stewardship Primary care |
| title | The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study |
| title_full | The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study |
| title_fullStr | The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study |
| title_full_unstemmed | The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study |
| title_short | The impact of penicillin allergy labels on antibiotic and health care use in primary care: a retrospective cohort study |
| title_sort | impact of penicillin allergy labels on antibiotic and health care use in primary care a retrospective cohort study |
| topic | Allergy registration Penicillin allergy Drug hypersensitivity Antimicrobial stewardship Primary care |
| url | http://link.springer.com/article/10.1186/s13601-017-0154-y |
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